Active NPI
Taylor Reynolds, RN
- Addiction (Substance Use Disorder) Registered Nurse
- Ironton, OH
National Provider Identifier
1508401779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Registered Nurse
- License
- RN.535900
- Practice address
- 2903 S 5TH St
Ironton, OH 45638-2866 - Phone
- (740) 646-6640
- NPI assigned
- Nov 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA173792 | OH | |
| Registered Nurse | 163W00000X | RN.535900 | OH | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | RN.535900 | OH | Primary |
Addresses
Primary practice location
2903 S 5TH St
Ironton, OH 45638-2866
Mailing address
323 Marion Pike Ste 3
Coal Grove, OH 45638-2958
Phone (740) 646-6640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0378862 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA173792 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| RN.535900 | OH | MD | Addiction (Substance Use Disorder) Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lawrence County Recovery, LLC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Ironton, OH
- NPI 1982266656
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718064000000",
"number": "1508401779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "323 MARION PIKE STE 3",
"city": "COAL GROVE",
"state": "OH",
"postal_code": "456382958",
"telephone_number": "740-646-6640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2903 S 5TH ST",
"city": "IRONTON",
"state": "OH",
"postal_code": "456382866",
"telephone_number": "740-646-6640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "TAYLOR",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-12",
"last_updated": "2024-06-11",
"certification_date": "2024-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA173792",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN.535900",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "163WA0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "RN.535900",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0378862",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ironton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.